OrganizationActive
Icco, LLC
NPI 1619558640 · Rural Health Clinic/Center · Dallas, OR
Provider details
- NPI number
- 1619558640
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Erica Hauser, Cfo(312) 590-5372
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
186 W Ellendale Ave
Dallas, OR 97338-1408
Phone: (971) 900-4984
Fax: (971) 900-4977
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 4858
Portland, OR 97208-4858
Other names (DBA / former)
- Doing business as
- Bestmed
Registry dates
- Enumerated
- 2021-04-20
- Last updated
- 2022-06-29
- Certified
- 2022-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.